Multiple accessory pathways in pediatric patients with Wolff-Parkinson-White syndrome.
Am J Cardiol
; 91(10): 1178-83, 2003 May 15.
Article
em En
| MEDLINE
| ID: mdl-12745099
ABSTRACT
The characteristics of multiple accessory pathways in children have not been previously studied. Records were reviewed of 317 consecutive pediatric patients with Wolff-Parkinson-White syndrome who underwent electrophysiologic study and radiofrequency catheter ablation at our institution. Twenty-eight patients (9%) had multiple pathways (a total of 64 pathways 21 patients had 2, 6 had 3, and 1 patient had 4 pathways). The locations were left free wall (22 pathways), right free wall (19 pathways), posteroseptal (17 pathways), and anteromidseptal (6 pathways). Of these 64 pathways, 55 were ablated successfully without complications, 5 failed ablation, and 4 fasciculoventricular fibers did not require treatment. Three patients had a newly found pathway at the repeat session. Three patients had atrioventricular nodal reentrant tachycardia and the slow pathway area was modified. One patient had failed initial ablation and had a successful ablation using a 3-dimensional electroanatomic mapping system. Compared with patients with a single pathway, those with multiple pathways exhibited a higher incidence of antidromic tachycardia, a shorter anterograde accessory pathway effective refractory period (<250 ms), a longer fluoroscopic time (65 +/- 43 vs 39 +/- 46 minutes, p <0.05), and a larger number of unsuccessful attempts (9 +/- 16 vs 5 +/- 8, p <0.05). Success rate (92% vs 93%) and recurrence rate (1.7% vs 2.1%) were similar in both groups. This study demonstrates that multiple pathways are not rare in pediatric patients and that multiple pathways contrast with a single pathway in a variety of conduction properties.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Síndrome de Wolff-Parkinson-White
/
Taquicardia por Reentrada no Nó Atrioventricular
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Sistema de Condução Cardíaco
Limite:
Adolescent
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Child
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Child, preschool
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Female
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Humans
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Male
Idioma:
En
Revista:
Am J Cardiol
Ano de publicação:
2003
Tipo de documento:
Article
País de afiliação:
Estados Unidos
País de publicação:
EEUU
/
ESTADOS UNIDOS
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ESTADOS UNIDOS DA AMERICA
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EUA
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UNITED STATES
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UNITED STATES OF AMERICA
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US
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USA